Missed radial head dislocations in children associated with ulnar deformation: treatment by open reduction and ulnar osteotomy

J Orthop Trauma. 2004 Jul;18(6):375-8. doi: 10.1097/00005131-200407000-00008.

Abstract

Objective: To evaluate the results of open reduction and ulnar osteotomy on missed Monteggia fractures in children.

Design: Retrospective review.

Setting: Tertiary care center orthopaedic hospital in Pellenberg, Belgium.

Patients/participants: Six children between 2 and 6 years old who sustained a Monteggia fracture that was initially missed were treated at our institute. They presented in our hospital 5 to 59 weeks postinjury.

Intervention: Open reduction of the radial head was performed, combined with a dorsal opening wedge osteotomy of the proximal ulna and fixation with plate and screws.

Main outcome measurements: Mobility of the elbow was measured by an independent observer, evaluating flexion-extension and pronation-supination preoperatively and postoperatively.

Results: All patients regained a normal range of motion, the radial head remained relocated, and the axis of the forearm remained normal.

Conclusion: This operation-open reduction of the radial head and osteotomy of the ulna-results in an excellent outcome for a missed Monteggia fracture in children.

MeSH terms

  • Child
  • Child, Preschool
  • Diagnostic Errors
  • Elbow Joint / physiopathology
  • Female
  • Fracture Fixation, Internal / methods*
  • Humans
  • Male
  • Monteggia's Fracture / complications
  • Monteggia's Fracture / diagnostic imaging
  • Monteggia's Fracture / surgery*
  • Osteotomy*
  • Radiography
  • Range of Motion, Articular
  • Retrospective Studies
  • Ulna / diagnostic imaging
  • Ulna / pathology*
  • Ulna / surgery*